N K Karn1, B S Rao, M M Prabhakar. 1. Department of Orthopaedics, BP Koirala Institute of Health Sciences, Dharan, Nepal. navinkarn@yahoo.com
Abstract
INTRODUCTION: This study assesses the role of new retractor system SynFrame for anterior decompression of tuberculosis of thoracolumbar junction of the spine. METHODS: This study includes five consecutive patients with tuberculosis of thoracolumbar junction treated with minimal invasive anterior decompression using a new table mounted retractor system SynFrame (Stratec Medical, Switzerland). The thoracolumbar junction was approached by a left sided thoracotomy. Short construct pedicle screw stabilization was done in all cases before decompression. The anterior column was reconstructed using expandable cage (n=3) and autologous tricortical graft (n=2). RESULTS: The mean operating time was 100 minutes (range 90-120). Mean overall blood loss was 400 ml. No operation had to change into an open procedure. There were neither intra nor postoperative complications related to minimal access in particular, nor visceral/vascular complications. CONCLUSIONS: The ring retractor system allows minimal open surgery to the spine by carrying different devices as well as endoscope, providing an excellent visualization of the operating field, and is safe and easy to use. The only disadvantage is its high cost.
INTRODUCTION: This study assesses the role of new retractor system SynFrame for anterior decompression of tuberculosis of thoracolumbar junction of the spine. METHODS: This study includes five consecutive patients with tuberculosis of thoracolumbar junction treated with minimal invasive anterior decompression using a new table mounted retractor system SynFrame (Stratec Medical, Switzerland). The thoracolumbar junction was approached by a left sided thoracotomy. Short construct pedicle screw stabilization was done in all cases before decompression. The anterior column was reconstructed using expandable cage (n=3) and autologous tricortical graft (n=2). RESULTS: The mean operating time was 100 minutes (range 90-120). Mean overall blood loss was 400 ml. No operation had to change into an open procedure. There were neither intra nor postoperative complications related to minimal access in particular, nor visceral/vascular complications. CONCLUSIONS: The ring retractor system allows minimal open surgery to the spine by carrying different devices as well as endoscope, providing an excellent visualization of the operating field, and is safe and easy to use. The only disadvantage is its high cost.